{ "_id": "5d48728057a11e8a91275c11", "calculate_sdes": null, "calculation_method": "EPISODE_OF_CARE", "cms_id": "CMS903v0", "component": false, "component_hqmf_set_ids": [ ], "composite": false, "composite_hqmf_set_id": null, "cql_libraries": [ { "_id": "5d48728057a11e8a91275c12", "cql": "library LikeCMS32 version '0.0.003'\n\n/*================================\neCQM ID: CMS902\nPatient-based: No\nScoring: continuous variable\nCMS Program Group: Eligible Hospitals (EH)\n================================*/\r\n\r\nusing QDM version '5.5'\r\n\r\ncodesystem \"SNOMEDCT\": 'urn:oid:2.16.840.1.113883.6.96'\r\n\r\nvalueset \"Discharge To Acute Care Facility\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.87'\r\nvalueset \"Emergency Department Visit\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.292'\r\nvalueset \"Encounter Inpatient\": 'urn:oid:2.16.840.1.113883.3.666.5.307'\r\nvalueset \"Ethnicity\": 'urn:oid:2.16.840.1.114222.4.11.837'\r\nvalueset \"Observation Services\": 'urn:oid:2.16.840.1.113762.1.4.1111.143'\r\nvalueset \"ONC Administrative Sex\": 'urn:oid:2.16.840.1.113762.1.4.1'\r\nvalueset \"Payer\": 'urn:oid:2.16.840.1.114222.4.11.3591'\r\nvalueset \"Psychiatric/Mental Health Diagnosis\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.299'\r\nvalueset \"Race\": 'urn:oid:2.16.840.1.114222.4.11.836'\r\n\r\ncode \"Patient deceased during stay (discharge status = dead) (finding)\": '371828006' from \"SNOMEDCT\" display 'Patient deceased during stay (discharge status = dead) (finding)'\r\n\r\nparameter \"Measurement Period\" Interval\r\n\r\ncontext Patient\r\n\r\ndefine \"SDE Ethnicity\":\r\n [\"Patient Characteristic Ethnicity\": \"Ethnicity\"]\r\n\r\ndefine \"SDE Payer\":\r\n [\"Patient Characteristic Payer\": \"Payer\"]\r\n\r\ndefine \"SDE Race\":\r\n [\"Patient Characteristic Race\": \"Race\"]\r\n\r\ndefine \"SDE Sex\":\r\n [\"Patient Characteristic Sex\": \"ONC Administrative Sex\"]\r\n\r\ndefine \"Emergency Department ED Visit\":\r\n [\"Encounter, Performed\": \"Emergency Department Visit\"] EDVisit\r\n where EDVisit.relevantPeriod during \"Measurement Period\"\r\n\r\ndefine \"Strat2\":\r\n \"Emergency Department ED Visit\" EDVisit\r\n where EDVisit.dischargeDisposition in \"Discharge To Acute Care Facility\"\r\n\r\ndefine \"Initial Population\":\r\n [\"Encounter, Performed\": \"Emergency Department Visit\"] EDVisit\r\n where EDVisit.relevantPeriod during \"Measurement Period\"\r\n\r\ndefine \"Measure Population\":\r\n \"Initial Population\" EDVisit\r\n where \"Measure Observation\"(EDVisit)is not null\r\n\r\ndefine \"Measure Population Exclusions\":\r\n ( \"Emergency Department ED Visit\" EDVisit\r\n where EDVisit.dischargeDisposition ~ \"Patient deceased during stay (discharge status = dead) (finding)\"\r\n )\r\n union ( \"Emergency Department ED Visit\" EDVisit\r\n with [\"Encounter, Performed\": \"Encounter Inpatient\"] Encounter\r\n such that EDVisit.relevantPeriod ends 1 hour or less before or on start of Encounter.relevantPeriod\r\n )\r\n\r\ndefine \"Strat1\":\r\n \"Emergency Department ED Visit\" EDVisit\r\n where exists ( EDVisit.diagnoses Diag\r\n where Diag.rank = 1\r\n and Diag.code in \"Psychiatric/Mental Health Diagnosis\"\r\n )\r\n\r\ndefine \"Strat3\":\r\n \"Emergency Department ED Visit\" EDVisit\r\n let DiagCode: GetPrincipalDiagnosisCode(EDVisit)\r\n where ( DiagCode is null\r\n or not ( DiagCode in \"Psychiatric/Mental Health Diagnosis\" )\r\n )\r\n and not ( EDVisit.dischargeDisposition in \"Discharge To Acute Care Facility\" )\r\n\r\ndefine function \"Observation Services Order\"(Enc \"Encounter, Performed\"):\r\n Last([\"Encounter, Order\": \"Observation Services\"] ObservationOrder\r\n where ObservationOrder.authorDatetime during Enc.relevantPeriod\r\n sort by authorDatetime\r\n )\r\n\r\ndefine function \"Departure Time\"(Enc \"Encounter, Performed\"):\r\n Last(Enc.facilityLocations Location\r\n return \r\n end of Location.locationPeriod\r\n sort ascending\r\n )\r\n\r\ndefine function \"Measure Observation\"(Enc \"Encounter, Performed\"):\r\n \"Arrival to Observation Order or Departure Time\"(Enc)\r\n\r\ndefine function \"ArrivalTime\"(Enc \"Encounter, Performed\"):\r\n First(Enc.facilityLocations Location\r\n return start of Location.locationPeriod\r\n sort ascending\r\n )\r\n\r\ndefine function \"Arrival to Observation Order or Departure Time\"(Enc \"Encounter, Performed\"):\r\n duration in minutes of Interval[\"ArrivalTime\"(Enc), Coalesce(\"Observation Services Order\"(Enc).authorDatetime, \"Departure Time\"(Enc))]\r\n\r\ndefine function \"GetPrincipalDiagnosisCode\"(Enc \"Encounter, Performed\"):\r\n singleton from ( Enc.diagnoses Diag\r\n where Diag.rank = 1\r\n return Diag.code\r\n )", "elm": { "library": { "identifier": { "id": "LikeCMS32", "version": "0.0.003" }, "schemaIdentifier": { "id": "urn:hl7-org:elm", "version": "r1" }, "usings": { "def": [ { "localIdentifier": "System", "uri": "urn:hl7-org:elm-types:r1" }, { "localId": "1", "locator": "10:1-10:23", "localIdentifier": "QDM", "uri": "urn:healthit-gov:qdm:v5_5", "version": "5.5" } ] }, "parameters": { "def": [ { "localId": "16", "locator": "26:1-26:49", "name": "Measurement Period", "accessLevel": "Public", "parameterTypeSpecifier": { "localId": "15", "locator": "26:32-26:49", "type": "IntervalTypeSpecifier", "pointType": { "localId": "14", "locator": "26:41-26:48", "name": "{urn:hl7-org:elm-types:r1}DateTime", "type": "NamedTypeSpecifier" } } } ] }, "codeSystems": { "def": [ { "localId": "2", "locator": "12:1-12:55", "name": "SNOMEDCT", "id": "2.16.840.1.113883.6.96", "accessLevel": "Public" } ] }, "valueSets": { "def": [ { "localId": "3", "locator": "14:1-14:87", "name": "Discharge To Acute Care Facility", "id": "2.16.840.1.113883.3.117.1.7.1.87", "accessLevel": "Public" }, { "localId": "4", "locator": "15:1-15:82", "name": "Emergency Department Visit", "id": "2.16.840.1.113883.3.117.1.7.1.292", "accessLevel": "Public" }, { "localId": "5", "locator": "16:1-16:71", "name": "Encounter Inpatient", "id": "2.16.840.1.113883.3.666.5.307", "accessLevel": "Public" }, { "localId": "6", "locator": "17:1-17:58", "name": "Ethnicity", "id": "2.16.840.1.114222.4.11.837", "accessLevel": "Public" }, { "localId": "7", "locator": "18:1-18:73", "name": "Observation Services", "id": "2.16.840.1.113762.1.4.1111.143", "accessLevel": "Public" }, { "localId": "8", "locator": "19:1-19:68", "name": "ONC Administrative Sex", "id": "2.16.840.1.113762.1.4.1", "accessLevel": "Public" }, { "localId": "9", "locator": "20:1-20:55", "name": "Payer", "id": "2.16.840.1.114222.4.11.3591", "accessLevel": "Public" }, { "localId": "10", "locator": "21:1-21:91", "name": "Psychiatric/Mental Health Diagnosis", "id": "2.16.840.1.113883.3.117.1.7.1.299", "accessLevel": "Public" }, { "localId": "11", "locator": "22:1-22:53", "name": "Race", "id": "2.16.840.1.114222.4.11.836", "accessLevel": "Public" } ] }, "codes": { "def": [ { "localId": "13", "locator": "24:1-24:175", "name": "Patient deceased during stay (discharge status = dead) (finding)", "id": "371828006", "display": "Patient deceased during stay (discharge status = dead) (finding)", "accessLevel": "Public", "codeSystem": { "localId": "12", "locator": "24:91-24:100", "name": "SNOMEDCT" } } ] }, "statements": { "def": [ { "locator": "28:1-28:15", "name": "Patient", "context": "Patient", "expression": { "type": "SingletonFrom", "operand": { "locator": "28:1-28:15", "dataType": "{urn:healthit-gov:qdm:v5_5}Patient", "templateId": "Patient", "type": "Retrieve" } } }, { "localId": "18", "locator": "30:1-31:51", "name": "SDE Ethnicity", "context": "Patient", "accessLevel": "Public", "annotation": [ { "type": "Annotation", "s": { "r": "18", "s": [ { "value": [ "define ", "\"SDE Ethnicity\"", ":\n " ] }, { "r": "17", "s": [ { "value": [ "[", "\"Patient Characteristic Ethnicity\"", ": " ] }, { "s": [ { "value": [ "\"Ethnicity\"" ] } ] }, { "value": [ "]" ] } ] } ] } } ], "expression": { "localId": "17", "locator": "31:3-31:51", "dataType": "{urn:healthit-gov:qdm:v5_5}PatientCharacteristicEthnicity", "codeProperty": "code", "type": "Retrieve", "codes": { "locator": "31:40-31:50", "name": "Ethnicity", "type": "ValueSetRef" } } }, { "localId": "20", "locator": "33:1-34:43", "name": "SDE Payer", "context": "Patient", "accessLevel": "Public", "annotation": [ { "type": "Annotation", "s": { "r": "20", "s": [ { "value": [ "define ", "\"SDE Payer\"", ":\n " ] }, { "r": "19", "s": [ { "value": [ "[", "\"Patient Characteristic Payer\"", ": " ] }, { "s": [ { "value": [ "\"Payer\"" ] } ] }, { "value": [ "]" ] } ] } ] } } ], "expression": { "localId": "19", "locator": "34:3-34:43", "dataType": "{urn:healthit-gov:qdm:v5_5}PatientCharacteristicPayer", "codeProperty": "code", "type": "Retrieve", "codes": { "locator": "34:36-34:42", "name": "Payer", "type": "ValueSetRef" } } }, { "localId": "22", "locator": "36:1-37:41", "name": "SDE Race", "context": "Patient", "accessLevel": "Public", "annotation": [ { "type": "Annotation", "s": { "r": "22", "s": [ { "value": [ "define ", "\"SDE Race\"", ":\n " ] }, { "r": "21", "s": [ { "value": [ "[", "\"Patient Characteristic Race\"", ": " ] }, { "s": [ { "value": [ "\"Race\"" ] } ] }, { "value": [ "]" ] } ] } ] } } ], "expression": { "localId": "21", "locator": "37:3-37:41", "dataType": "{urn:healthit-gov:qdm:v5_5}PatientCharacteristicRace", "codeProperty": "code", "type": "Retrieve", "codes": { "locator": "37:35-37:40", "name": "Race", "type": "ValueSetRef" } } }, { "localId": "24", "locator": "39:1-40:58", "name": "SDE Sex", "context": "Patient", "accessLevel": "Public", "annotation": [ { "type": "Annotation", "s": { "r": "24", "s": [ { "value": [ "define ", "\"SDE Sex\"", ":\n " ] }, { "r": "23", "s": [ { "value": [ "[", "\"Patient Characteristic Sex\"", ": " ] }, { "s": [ { "value": [ "\"ONC Administrative Sex\"" ] } ] }, { "value": [ "]" ] } ] } ] } } ], "expression": { "localId": "23", "locator": "40:3-40:58", "dataType": "{urn:healthit-gov:qdm:v5_5}PatientCharacteristicSex", "codeProperty": "code", "type": "Retrieve", "codes": { "locator": "40:34-40:57", "name": "ONC Administrative Sex", "type": "ValueSetRef" } } }, { "localId": "32", "locator": "42:1-44:60", "name": "Emergency Department ED Visit", "context": "Patient", "accessLevel": "Public", "annotation": [ { "type": "Annotation", "s": { "r": "32", "s": [ { "value": [ "define ", "\"Emergency Department ED Visit\"", ":\n " ] }, { "r": "31", "s": [ { "s": [ { "r": "26", "s": [ { "r": "25", "s": [ { "r": "25", "s": [ { "value": [ "[", "\"Encounter, Performed\"", ": " ] }, { "s": [ { "value": [ "\"Emergency Department Visit\"" ] } ] }, { "value": [ "]" ] } ] } ] }, { "value": [ " ", "EDVisit" ] } ] } ] }, { "value": [ "\n " ] }, { "r": "30", "s": [ { "value": [ "where " ] }, { "r": "30", "s": [ { "r": "28", "s": [ { "r": "27", "s": [ { "value": [ "EDVisit" ] } ] }, { "value": [ "." ] }, { "r": "28", "s": [ { "value": [ "relevantPeriod" ] } ] } ] }, { "r": "30", "value": [ " ", "during", " " ] }, { "r": "29", "s": [ { "value": [ "\"Measurement Period\"" ] } ] } ] } ] } ] } ] } } ], "expression": { "localId": "31", "locator": "43:3-44:60", "type": "Query", "source": [ { "localId": "26", "locator": "43:3-43:64", "alias": "EDVisit", "expression": { "localId": "25", "locator": "43:3-43:56", "dataType": "{urn:healthit-gov:qdm:v5_5}PositiveEncounterPerformed", "templateId": "PositiveEncounterPerformed", "codeProperty": "code", "type": "Retrieve", "codes": { "locator": "43:28-43:55", "name": "Emergency Department Visit", "type": "ValueSetRef" } } } ], "relationship": [ ], "where": { "localId": "30", "locator": "44:5-44:60", "type": "IncludedIn", "operand": [ { "localId": "28", "locator": "44:11-44:32", "path": "relevantPeriod", "scope": "EDVisit", "type": "Property" }, { "localId": "29", "locator": "44:41-44:60", "name": "Measurement Period", "type": "ParameterRef" } ] } } }, { "localId": "40", "locator": "46:1-48:76", "name": "Strat2", "context": "Patient", "accessLevel": "Public", "annotation": [ { "type": "Annotation", "s": { "r": "40", "s": [ { "value": [ "define ", "\"Strat2\"", ":\n " ] }, { "r": "39", "s": [ { "s": [ { "r": "34", "s": [ { "r": "33", "s": [ { "s": [ { "value": [ "\"Emergency Department ED Visit\"" ] } ] } ] }, { "value": [ " ", "EDVisit" ] } ] } ] }, { "value": [ "\n " ] }, { "r": "38", "s": [ { "value": [ "where " ] }, { "r": "38", "s": [ { "r": "36", "s": [ { "r": "35", "s": [ { "value": [ "EDVisit" ] } ] }, { "value": [ "." ] }, { "r": "36", "s": [ { "value": [ "dischargeDisposition" ] } ] } ] }, { "value": [ " in " ] }, { "r": "37", "s": [ { "value": [ "\"Discharge To Acute Care Facility\"" ] } ] } ] } ] } ] } ] } } ], "expression": { "localId": "39", "locator": "47:3-48:76", "type": "Query", "source": [ { "localId": "34", "locator": "47:3-47:41", "alias": "EDVisit", "expression": { "localId": "33", "locator": "47:3-47:33", "name": "Emergency Department ED Visit", "type": "ExpressionRef" } } ], "relationship": [ ], "where": { "localId": "38", "locator": "48:5-48:76", "type": "InValueSet", "code": { "localId": "36", "locator": "48:11-48:38", "path": "dischargeDisposition", "scope": "EDVisit", "type": "Property" }, "valueset": { "localId": "37", "locator": "48:43-48:76", "name": "Discharge To Acute Care Facility" } } } }, { "localId": "48", "locator": "50:1-52:60", "name": "Initial Population", "context": "Patient", "accessLevel": "Public", "annotation": [ { "type": "Annotation", "s": { "r": "48", "s": [ { "value": [ "define ", "\"Initial Population\"", ":\n " ] }, { "r": "47", "s": [ { "s": [ { "r": "42", "s": [ { "r": "41", "s": [ { "r": "41", "s": [ { "value": [ "[", "\"Encounter, Performed\"", ": " ] }, { "s": [ { "value": [ "\"Emergency Department Visit\"" ] } ] }, { "value": [ "]" ] } ] } ] }, { "value": [ " ", "EDVisit" ] } ] } ] }, { "value": [ "\n " ] }, { "r": "46", "s": [ { "value": [ "where " ] }, { "r": "46", "s": [ { "r": "44", "s": [ { "r": "43", "s": [ { "value": [ "EDVisit" ] } ] }, { "value": [ "." ] }, { "r": "44", "s": [ { "value": [ "relevantPeriod" ] } ] } ] }, { "r": "46", "value": [ " ", "during", " " ] }, { "r": "45", "s": [ { "value": [ "\"Measurement Period\"" ] } ] } ] } ] } ] } ] } } ], "expression": { "localId": "47", "locator": "51:3-52:60", "type": "Query", "source": [ { "localId": "42", "locator": "51:3-51:64", "alias": "EDVisit", "expression": { "localId": "41", "locator": "51:3-51:56", "dataType": "{urn:healthit-gov:qdm:v5_5}PositiveEncounterPerformed", "templateId": "PositiveEncounterPerformed", "codeProperty": "code", "type": "Retrieve", "codes": { "locator": "51:28-51:55", "name": "Emergency Department Visit", "type": "ValueSetRef" } } } ], "relationship": [ ], "where": { "localId": "46", "locator": "52:5-52:60", "type": "IncludedIn", "operand": [ { "localId": "44", "locator": "52:11-52:32", "path": "relevantPeriod", "scope": "EDVisit", "type": "Property" }, { "localId": "45", "locator": "52:41-52:60", "name": "Measurement Period", "type": "ParameterRef" } ] } } }, { "localId": "66", "locator": "98:1-102:3", "name": "ArrivalTime", "context": "Patient", "accessLevel": "Public", "type": "FunctionDef", "annotation": [ { "type": "Annotation", "s": { "r": "66", "s": [ { "value": [ "define function ", "\"ArrivalTime\"", "(", "Enc", " " ] }, { "r": "56", "s": [ { "value": [ "\"Encounter, Performed\"" ] } ] }, { "value": [ " ):\n " ] }, { "r": "65", "s": [ { "r": "65", "s": [ { "value": [ "First", "(" ] }, { "r": "64", "s": [ { "s": [ { "r": "58", "s": [ { "r": "57", "s": [ { "s": [ { "value": [ "Enc", ".", "facilityLocations" ] } ] } ] }, { "value": [ " ", "Location" ] } ] } ] }, { "value": [ "\n " ] }, { "r": "62", "s": [ { "value": [ "return " ] }, { "r": "61", "s": [ { "value": [ "start of " ] }, { "r": "60", "s": [ { "r": "59", "s": [ { "value": [ "Location" ] } ] }, { "value": [ "." ] }, { "r": "60", "s": [ { "value": [ "locationPeriod" ] } ] } ] } ] } ] }, { "r": "63", "value": [ "\n ", "sort ascending" ] } ] }, { "value": [ "\n )" ] } ] } ] } ] } } ], "expression": { "localId": "65", "locator": "99:3-102:3", "type": "First", "source": { "localId": "64", "locator": "99:9-101:20", "type": "Query", "source": [ { "localId": "58", "locator": "99:9-99:38", "alias": "Location", "expression": { "localId": "57", "locator": "99:9-99:29", "path": "facilityLocations", "type": "Property", "source": { "name": "Enc", "type": "OperandRef" } } } ], "relationship": [ ], "return": { "localId": "62", "locator": "100:7-100:45", "expression": { "localId": "61", "locator": "100:14-100:45", "type": "Start", "operand": { "localId": "60", "locator": "100:23-100:45", "path": "locationPeriod", "scope": "Location", "type": "Property" } } }, "sort": { "localId": "63", "locator": "101:7-101:20", "by": [ { "direction": "asc", "type": "ByDirection" } ] } } }, "operand": [ { "name": "Enc", "operandTypeSpecifier": { "localId": "56", "locator": "98:35-98:56", "name": "{urn:healthit-gov:qdm:v5_5}PositiveEncounterPerformed", "type": "NamedTypeSpecifier" } } ] }, { "localId": "82", "locator": "82:1-86:3", "name": "Observation Services Order", "context": "Patient", "accessLevel": "Public", "type": "FunctionDef", "annotation": [ { "type": "Annotation", "s": { "r": "82", "s": [ { "value": [ "define function ", "\"Observation Services Order\"", "(", "Enc", " " ] }, { "r": "69", "s": [ { "value": [ "\"Encounter, Performed\"" ] } ] }, { "value": [ " ):\n " ] }, { "r": "81", "s": [ { "r": "81", "s": [ { "value": [ "Last", "(" ] }, { "r": "80", "s": [ { "s": [ { "r": "71", "s": [ { "r": "70", "s": [ { "r": "70", "s": [ { "value": [ "[", "\"Encounter, Order\"", ": " ] }, { "s": [ { "value": [ "\"Observation Services\"" ] } ] }, { "value": [ "]" ] } ] } ] }, { "value": [ " ", "ObservationOrder" ] } ] } ] }, { "value": [ "\n " ] }, { "r": "76", "s": [ { "value": [ "where " ] }, { "r": "76", "s": [ { "r": "73", "s": [ { "r": "72", "s": [ { "value": [ 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